Gliederung

Introduction: Skin flap necrosis caused by insufficient blood supply is a common complication in reconstructive surgery. A number of methods have been described to augment viability of skin flaps. Adipose derived stem cells (ASCs) have the potential for differentiation into several types of cells, including vascular endothelial cells. Thus, the purpose of this study was to determine the potential of ASCs to enhance skin flap survival in an animal epigastric skin flap model.

Materials and methods: ASCs were isolated from Lewis rats and cultured in vitro. Fibrin glue was used for in vivo transfer and local application of cultivated ASCs. Twenty-four rats were divided into 3 groups and an extended epigastric adipocutaneous flap was raised. In group 1, ASCs were applicated in the subcutaneous layer between skin and muscle before the flap was sutured back to its native configuration. Group 2 received medium only and fibrin glue and served as a control group. In group 3 the flap was raised and immediately sutured back without any treatment (sham control group). Five days postoperatively, flap survival, perfusion and microvessel- density were assessed.

Results: Treatment with ASCs significantly increased flap survival (93.6Â±11.3% vs. 84.7Â±5.4%; p<0.012) and flap perfusion (93.5Â±6.9% vs. 84.5Â±5.2%; p<0.012) when compared to the control group 2 or sham operated group 3 (81.9Â±4.2%; p<0.001 and 82.3Â±3.9%; p<0.002). Microvessel- density in ASCs treated group was significantly increased when compared to the control group 2 (33.56Â±6.36% vs. 22.88Â±4.65%; p=0.002). No significant differences showed the comparison of the experimental group and the sham operated control group

Conclusion: Our data show that the local application of ASCs increase tissue survival, blood flow and microvessel density